Physicians Voice Concerns on Texas Law that Restricts Immunizations for Foster Children

A new Texas law will restrict when children in state custody can receive emergency vaccinations.

Texas Governor Greg Abbott has signed into law a bill that was designed to improve various aspects of the Child Protective Services in the state. However, one component of the bill was an amendment, made by Republican Bill Zedler, R-Arlington, would prevent emergency immunizations from being given to children who are removed from their homes and placed in foster care.

Anu Partap, MD, MPH, Assistant Professor of Pediatrics at the University of Texas Southwestern Medical Center, says under the new law doctors would now need to wait until a particular court hearing is conducted. Such hearings are supposed to occur about two weeks after a child is removed from a home, but these hearings can be delayed.

"[These children] are the only group who we will be knowingly delaying immunizations for," said Partap, who also serves as Director of the Rees-Jones Center for Foster Care Excellence at Children's Health.

The exception, she said, would be tetanus shots, which would be allowed in emergency situations.

Zedler made the amendment after voicing concern that medical decisions could be made that would contradict a parent's wish for their child.

"Immunizations do not qualify as emergency care," he said in an article published by the Dallas Morning News about the issue. "No vaccine cures a disease."

However, physicians, including Partap, have voiced their concerns about the new law and the implications it could have on the approximately 17,000 children who pass through the state's foster care system each year.

"A lot of kids who enter foster care have either fallen behind on their shots or their records are scattered, but either way there is a period of time where they are under immunized, or unimmunized, and so they are at risk for picking up infections that we know we can prevent them from getting," Partap said.

According to the Associated Press, approval of the bill comes at a time when more Texas parents are opting against vaccinations. The AP reported that more than 44,000 parents in Texas filed personal belief exemptions with the state during the last school year, 20 times the numbers of exemptions requested in 2003.

One of Partap's concerns is that when children who are unimmunized or under immunized are placed in foster care homes with other children they may actually be placing the whole household at risk.

She says it may also be more difficult to keep track of who has received vaccinations and who hasn't, because many foster care children change households more frequently.

In the past, Partap said physicians typically looked at state immunizations records and decided whether to provide immunizations based on the child's age and risk.

"With the new law, even once we verify with certainty that a child is behind, CPS and foster parents can't consent to needed immunizations, regardless of risk, unless it's an emergency tetanus," she says.

These children could also be more vulnerable during disease outbreaks. "There is no exception to allow earlier immunization during outbreaks and outbreaks are becoming more frequent," Partap said.